Question

A patient with coronary artery disease presents to you with chest pain and palpitations. The ECG is shown below. Which of the following can be used in the management?

• A. Oral metoprolol
• B. Oral amiodarone
• C. Intravenous amiodarone
• D. Intravenous metoprolol

Answer 1

The Correct Option is C

In the management of a patient with coronary artery disease who presents with chest pain and palpitations, and based on the provided ECG, it is essential to address the possible presence of arrhythmias that could be life-threatening. Arrhythmias, particularly in the context of coronary artery disease, can lead to complications like ischemia, and prompt treatment is crucial. Among the options given:

• Oral metoprolol - A beta-blocker, typically used for long-term management of stable symptoms and rate control, but not immediately suitable for acute management of significant arrhythmias in a critical scenario.
• Oral amiodarone - While effective for rhythm control, the oral form does not provide the rapid onset needed in acute situations.
• Intravenous amiodarone - Offers the fastest onset of action to stabilize life-threatening arrhythmias, making it suitable for acute management.
• Intravenous metoprolol - Although useful for rate control, it may not be the best option when rapid rhythm stabilization is required.

Given these considerations, the most appropriate choice for the management of this patient, due to its rapid action and effectiveness in managing severe arrhythmias, is Intravenous amiodarone. This choice helps in quickly stabilizing the patient's cardiac rhythm in an acute setting, addressing the immediate threat of the arrhythmia.